The Dilator Program

The goal of the dilator program is to run through four types of movements with each dilator size until you are able to use a dilator the girth of your erect partner or desired penetrating item.  Start with the smallest girth dilator.

 Movement One:  Insertion.  Can you get the dilator in without more than 2 out of 10 discomfort?  If you can only get it in a little bit and start to feel more than a 2, then you must stop and do your diaphragmatic breathing and anal relaxation. With your ten-minute time limit, this realistically means that you may not be able to insert a dilator in completely for a few days or even a few weeks.  But, no one is judging you but you (or maybe a partner – but that isn’t supportive and that in itself is indicative of one or several issues).  I’m not judging you.  I’m telling you that slow and steady wins the race.  Be patient with yourself and you will be much more successful. Once you’ve gotten your first dilator in all the way, you will notice that a portion of the dilator doesn’t go into the vaginal canal.  This is the part for you to hold.  You will also likely notice that if you don’t hold the end of the dilator, your own vaginal muscles will slowly start pushing the dilator out – not all the way out, but you will see some slow movement.  That is also to be expected and natural. 

 Movement Two:  Rotation.  We want to teach the tissue at the opening of the vagina and inside the vagina (and we want to teach your brain) that movement in all directions is okay.  Not just okay, but not worthy of worry or anxiety.  So now the dilator is completely in the vaginal canal and you can slowly turn it like a dial.  Slowly turn it all the way to the left and then all the way to the right.  The same rules apply:  no more than 2 out of 10 discomfort is allowed and the whole process from insertion to removal cannot take more than ten minutes.  Once this is no big deal to your body and brain, you can move on.

Movement Three: Pressure.  With the dilator inserted completely, take the end that is sticking out of the vaginal canal and put pressure at the vaginal opening.  You will take turns putting gentle pressure all around the opening of the vagina.  Imagine that the vaginal opening is the face of a clock.  12 o’clock is correlated to the direction of the clitoris.  6 o’clock is correlated to the direction of the anus.  Gently place pressure at all the “hours” of the clock, but it is not necessary to do this at 12 o’clock.  The urethra sits there so it won’t be comfortable to put isolated pressure right under the urethra. 

 Movement Four: This is the last step of the progressions used with one dilator size before moving to the next size.  With the dilator inserted completely, remove the dilator halfway out of the vaginal canal and then re-insert completely.  This can be done slowly.  Again, the 2 out of 10 discomfort rule applies.  This is a different direction of movement and simulates penetrative directions.  With this last movement, the opening of the vagina and the vaginal canal have now experienced a slow stretch and different directions of movement.  This takes the nerve endings and gives them gentle and tolerable input that re-trains the brain.  This very benign pressure tells the brain “something is there, I feel it, but this isn’t ‘damage’ so I don’t interpret this as pain”. 

 Once these four movements have been accomplished without more than 2 out of 10 discomfort and in under 10 minutes, then you are ready to move forward with the next dilator size.  

There are a lot of dilator companies. I like dilator companies that create half sizes, so I often recommend Syracuse dilators.  They are cheaper, firm and do have half-sizes.  If someone is having penetrative sex that hurts, I will typically start them on a small or small plus.  However, is someone cannot have penetration yet, then that is a different ball game.  I might start them on a long-stemmed Q-tip.  This is still truly a dilator and you can go through all the movements with it before moving onto a dilator that you order.  Syracuse dilators makes sizes as small as XXS.  I love that and if that’s where you are at, you will love it too.  I progress people to dilator sizes that are either as big as their partner’s or their penetrating item’s firmest girth. 

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